The CAMINO intracranial pressure device in clinical practice: Reliability,handling characteristics and complications

Intracranial pressure monitoring has a key role in the management of patien ts developing increased intracranial pressure (ICP). We adopted the Camino fiberoptic system for intracranial pressure measurement in 1993 in our neur osurgical department. The aim of this study was to investigate reliability, handling characteristics and complication rate of the Camino intracranial pressure device. In an eighteen month period, we prospectively investigated 118 patients wit h intracranial pathology undergoing Camino fiberoptic intraparenchymal or i ntraventricular ICP monitoring. The assessment of reliability of ICP monito ring according to patients clinical condition. to cranial computed tomograp hy (CCT) findings and ICP waveform was carried out. Position of the probe a nd intracranial bleeding complications related to probe insertion were conf irmed by CCT. Technical complications, as well as infections due to the de vice, were documented. In vivo recalibration was performed in 22 patients. At the end of the measuring period the drift of the probe was evaluated and the accuracy of the fiberoptic device was measured by performing a two poi nt calibration. Recordings of intracranial pressure were carried out with 136 Camino device s (104 parenchymal, 32 ventricular) in 118 patients with an average measuri ng time of 94.1 +/- 79.1 hrs. One hundred and fifteen Camino intracranial p ressure devices (85.2%) demonstrated reliability according to the predeterm ined clinical parameters. The actual mean drift after removal of the device s was 3.4 mmHg +/- 3.2 with an actual daily drift of 3.2 +/- 17.2 mmHg. Rec orded complications included infection (0.7%), intraparenchymal haematoma ( 5.1%), and a high complication rate (23.5%) with regard to technical aspect s. The Camino intracranial pressure system offers reliable ICP measurements in an acceptable percentage of devices, and the advantage of in vivo recal ibration. The high incidence of technical complications identifies a need f or improvement in the fiberoptic cable and the fixation system.